Compression Stockings or Compression Socks

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If you have varicose veins or non-healing ulcers caused by venous insufficiency, your doctor will “need” to recommend compression stockings (also known as support hose or compression socks) as the first line of treatment. This obligation is based on insurance carriers requirements that mandate a trial of conservative therapy. It’s not unusual for these companies to necessitate at least 6 weeks of such treatment despite the fact that there is absolutely no science behind this recommendation. In a Guidelines Summary paper from the American College of Phlebology, the following was mentioned regarding the need for compression stockings prior to definitive venous reflux treatment:

The intended purpose of compression therapy

“Compression therapy is an effective method for the management of symptoms related to superficial disease but it does not correct the source of reflux. When patients have a correctable source of reflux definitive treatment should also be offered unless it is contraindicated or unwanted. We recommend against compression therapy as a prerequisite therapy for symptomatic venous reflux disease when other definitive treatments such as endovenous ablation are appropriate.”

This statement is a strong recommendation against the need for conservative care and is based on high-quality medical evidence. Many years ago when the only option for treating varicose veins was major surgery, it made sense to try conservative care as the alternative to definitive therapy. Today, there is no excuse for it.

How compression stockings work

Compression stockings squeeze your legs in order to help push blood up against gravity towards your heart. While compression stockings are an effective treatment for certain conditions, exactly how they improve the healing process is not entirely clear to scientists yet. What is known, however, is that compression stockings improve blood flow in the legs and help reduce swelling by moving extra fluids in the legs into a type of blood vessel called lymphatic channels, which carry them away. They also help prevent blood clots.

Uses and benefits of compression socks

As noted above, Insurance companies require patients try conservative therapy such as compression stockings first before becoming eligible for other vein treatments. Doctors also prescribe the use of compression stockings after other vein treatments such as sclerotherapy or surgery in order to improve healing and outcomes and reduce complications.

Wearing compression stockings while flying is an effective preventative measure to help reduce the risk for deep vein thrombosis (DVT), a serious, potentially life-threatening condition where blood clots form, typically in the legs, and then move to the lungs. One of the risk factors for DVT is sitting for long periods of time, such as when flying or traveling by car.

Compression stockings have also been shown to help alleviate these symptoms in certain cases:

•Aches and pains

•Sensation of heaviness

•Swelling

•Healing vein-related ulcers and wounds

•Vein-related sleep problems

Of note, people without any underlying vein disorder report that their legs feel better after wearing stockings compared to those who don’t don the garments.

The big challenge with support hose

Following your doctor's orders and actually wearing the stockings as prescribed is the main challenge in compression therapy. But good news: There are a variety of styles to choose from, and in addition to different lengths and strengths, they now come in all kinds of fashion colors and patterns. Thus, today's compression stockings don't scream "medical hosiery," and worn under pants, they're completely invisible.

Talc or cornstarch helps compression socks to glide a little easier, if you find putting them on challenging. There are also devices designed to make it easier to put compression stockings on, if you have weak hands or arthritis. But you could also try buying gloves with little rubber dots. While these are sold in medical supply stores, a cheaper version is often available at gas stations. These gloves really help you grip the stockings. Lastly, one of the most frequent complaints relates to the garment sliding down patient’s legs. One trick to avoid this is to use rubbing alcohol on the elastic strap or if needed a special adhesive.

Costs of compression stockings

Stockings can range in price anywhere from about $20 to more than $100 and are occasionally covered by your insurance. If you're wearing your compression stockings long term, replace them every three to six months, because over time they tend to stretch out and lose their strength and effectiveness.